Florida Senate - 2009 SB 476 By Senator Sobel 31-00549-09 2009476__ 1 A bill to be entitled 2 An act relating to emergency management; creating part 3 V of ch. 252, F.S., the Uniform Emergency Volunteer 4 Health Practitioners Act; providing definitions; 5 providing for applicability of the act to specified 6 volunteer health practitioners; providing for the 7 regulation of specified health services by the 8 Division of Emergency Management of the Department of 9 Community Affairs, in cooperation with the Department 10 of Health, the Agency for Health Care Administration, 11 and the Board of Veterinary Medicine, while an 12 emergency declaration is in effect; providing 13 requirements with respect to volunteer health 14 practitioner registration systems; providing 15 procedures with respect to the use of such systems; 16 authorizing specified volunteer health practitioners 17 who are licensed outside the state to practice in this 18 state; providing limitations with respect to the 19 protections afforded under the act; defining 20 “credentialing” and “privileging”; providing that the 21 act does not affect the credentialing or privileging 22 standards of a health facility and does not preclude a 23 health facility from waiving or modifying those 24 standards while an emergency declaration is in effect; 25 providing for regulation, modification, and 26 restriction of health or veterinary services provided 27 by volunteer health practitioners under the act; 28 providing for imposition of administrative sanctions 29 under specified conditions; providing for relation of 30 the act to other laws; authorizing the Division of 31 Emergency Management, the Department of Health, the 32 Agency for Health Care Administration, and the Board 33 of Veterinary Medicine to adopt rules; providing 34 limitations on civil liability for volunteer health 35 practitioners; providing for vicarious liability; 36 providing for workers' compensation coverage under the 37 act; providing duties and responsibilities of the 38 Division of Emergency Management, the Department of 39 Health, the Agency for Health Care Administration, and 40 the Board of Veterinary Medicine with respect to 41 workers' compensation coverage, including the adoption 42 of rules; providing for uniformity of application and 43 construction of the act; providing an effective date. 44 45 Be It Enacted by the Legislature of the State of Florida: 46 47 Section 1. Part V of chapter 252, Florida Statutes, 48 consisting of sections 252.951, 252.952, 252.953, 252.954, 49 252.955, 252.956, 252.957, 252.958, 252.959, 252.960, 252.961, 50 252.962, and 252.963, is created to read: 51 PART V 52 UNIFORM EMERGENCY VOLUNTEER HEALTH PRACTITIONERS ACT 53 252.951 Short title.—This part may be cited as the “Uniform 54 Emergency Volunteer Health Practitioners Act.” 55 252.952 Definitions.—As used in this part: 56 (1) “Board of Veterinary Medicine” means the Board of 57 Veterinary Medicine within the Division of Professions of the 58 Department of Business and Professional Regulation. 59 (2) “Disaster relief organization” means an entity that 60 provides emergency or disaster relief services that include 61 health or veterinary services provided by volunteer health 62 practitioners and that: 63 (a) Is designated or recognized as a provider of those 64 services pursuant to a disaster response and recovery plan 65 adopted by an agency of the Federal Government or an agency or 66 political subdivision of this state; or 67 (b) Regularly plans and conducts its activities in 68 coordination with an agency of the Federal Government or an 69 agency or political subdivision of this state. 70 (3) “Division of Emergency Management” or “division” means 71 the Division of Emergency Management of the Department of 72 Community Affairs. 73 (4) “Emergency” has the same meaning as that term is 74 defined in s. 252.34(3). 75 (5) “Emergency declaration” means the declaration of a 76 state of emergency by executive order or proclamation of the 77 Governor as provided under s. 252.36. 78 (6) “Emergency Management Assistance Compact” means the 79 interstate compact approved by Congress by Pub. L. No. 104-321, 80 110 Stat. 3877, codified as part III of this chapter. 81 (7) “Entity” means a person other than an individual. 82 (8) “Health facility” means an entity licensed under the 83 laws of this or another state to provide health or veterinary 84 services. 85 (9) “Health practitioner” means an individual licensed 86 under the laws of this or another state to provide health or 87 veterinary services. 88 (10) “Health services” means the provision of treatment, 89 care, advice or guidance, or other services, or supplies, 90 related to the health or death of individuals or human 91 populations, to the extent necessary to respond to an emergency, 92 including: 93 (a) The following, concerning the physical or mental 94 condition or functional status of an individual or affecting the 95 structure or function of the body: 96 1. Preventive, diagnostic, therapeutic, rehabilitative, 97 maintenance, or palliative care; and 98 2. Counseling, assessment, procedures, or other services; 99 (b) Sale or dispensing of a drug, a device, equipment, or 100 other item to an individual in accordance with a prescription; 101 and 102 (c) Funeral, cremation, cemetery, or other mortuary 103 services. 104 (11) “Host entity” means an entity operating in this state 105 which uses volunteer health practitioners to respond to an 106 emergency. 107 (12) “License” means authorization by a state to engage in 108 health or veterinary services that are unlawful without the 109 authorization. The term includes authorization under the laws of 110 this state to an individual to provide health or veterinary 111 services based upon a national certification issued by a public 112 or private entity. 113 (13) “Person” means an individual, corporation, business 114 trust, trust, partnership, limited liability company, 115 association, joint venture, public corporation, government or 116 governmental subdivision, agency, or instrumentality, or any 117 other legal or commercial entity. 118 (14) “Scope of practice” means the extent of the 119 authorization to provide health or veterinary services granted 120 to a health practitioner by a license issued to the practitioner 121 in the state in which the principal part of the practitioner's 122 services are rendered, including any conditions imposed by the 123 licensing authority. 124 (15) “State” means a state of the United States, the 125 District of Columbia, Puerto Rico, the United States Virgin 126 Islands, or any territory or insular possession subject to the 127 jurisdiction of the United States. 128 (16) “Veterinary services” means the provision of 129 treatment, care, advice or guidance, or other services, or 130 supplies, related to the health or death of an animal or to 131 animal populations, to the extent necessary to respond to an 132 emergency, including: 133 (a) Diagnosis, treatment, or prevention of an animal 134 disease, injury, or other physical or mental condition by the 135 prescription, administration, or dispensing of vaccine, 136 medicine, surgery, or therapy; 137 (b) Use of a procedure for reproductive management; and 138 (c) Monitoring and treatment of animal populations for 139 diseases that have spread or demonstrate the potential to spread 140 to humans. 141 (17) “Volunteer health practitioner” means a health 142 practitioner who provides health or veterinary services, whether 143 or not the practitioner receives compensation for those 144 services. The term does not include a practitioner who receives 145 compensation pursuant to a preexisting employment relationship 146 with a host entity or affiliate which requires the practitioner 147 to provide health services in this state, unless the 148 practitioner is not a resident of this state and is employed by 149 a disaster relief organization providing services in this state 150 while an emergency declaration is in effect. 151 252.953 Applicability to volunteer health practitioners. 152 This part applies to volunteer health practitioners registered 153 with a registration system that complies with s. 252.955 and who 154 provide health or veterinary services in this state for a host 155 entity while an emergency declaration is in effect. 156 252.954 Regulation of services during emergency.— 157 (1) While an emergency declaration is in effect, the 158 Division of Emergency Management, in conjunction with the 159 Department of Health, the Agency for Health Care Administration, 160 and the Board of Veterinary Medicine, may limit, restrict, or 161 otherwise regulate: 162 (a) The duration of practice by volunteer health 163 practitioners; 164 (b) The geographical areas in which volunteer health 165 practitioners may practice; 166 (c) The types of volunteer health practitioners who may 167 practice; and 168 (d) Any other matters necessary to coordinate effectively 169 the provision of health or veterinary services during the 170 emergency. 171 (2) An order issued pursuant to subsection (1) may take 172 effect immediately, without prior notice or comment, and is not 173 a rule pursuant to chapter 120. 174 (3) A host entity that uses volunteer health practitioners 175 to provide health or veterinary services in this state shall: 176 (a) Consult and coordinate its activities with the Division 177 of Emergency Management, the Department of Health, the Agency 178 for Health Care Administration, and the Board of Veterinary 179 Medicine to the extent practicable to provide for the efficient 180 and effective use of volunteer health practitioners; and 181 (b) Comply with any laws other than this part relating to 182 the management of emergency health or veterinary services. 183 252.955 Volunteer health practitioner registration 184 systems.— 185 (1) To qualify as a volunteer health practitioner 186 registration system, a system must: 187 (a) Accept applications for the registration of volunteer 188 health practitioners before or during an emergency; 189 (b) Include information about the licensure and good 190 standing of health practitioners which is accessible by 191 authorized persons; 192 (c) Be capable of confirming the accuracy of information 193 concerning whether a health practitioner is licensed and in good 194 standing before health services or veterinary services are 195 provided under this part; and 196 (d) Meet one of the following conditions: 197 1. Be an emergency system for advance registration of 198 volunteer health practitioners established by a state and funded 199 through the United States Department of Health and Human 200 Services under Section 319I of the United States Public Health 201 Services Act, 42 U.S.C. s. 247d-7b, as amended; 202 2. Be a local unit consisting of trained and equipped 203 emergency response, public health, and medical personnel formed 204 pursuant to Section 2801 of the United States Public Health 205 Services Act, 42 U.S.C. s. 300hh, as amended; 206 3. Be operated by a: 207 a. Disaster relief organization; 208 b. Licensing board; 209 c. National or regional association of licensing boards or 210 health practitioners; 211 d. Health facility that provides comprehensive inpatient 212 and outpatient health care services, including a tertiary care 213 and teaching hospital; or 214 e. Governmental entity; or 215 4. Be designated by the Division of Emergency Management, 216 in cooperation with the Department of Health, the Agency for 217 Health Care Administration, and the Board of Veterinary 218 Medicine, as a registration system for purposes of this part. 219 (2) While an emergency declaration is in effect, the 220 Division of Emergency Management, the Department of Health, the 221 Agency for Health Care Administration, and the Board of 222 Veterinary Medicine, a person authorized to act on behalf of the 223 division, department, agency, or board, or a host entity may 224 confirm whether volunteer health practitioners utilized in this 225 state are registered with a registration system that complies 226 with subsection (1). Confirmation is limited to obtaining 227 identities of the practitioners from the system and determining 228 whether the system indicates that the practitioners are licensed 229 and in good standing. 230 (3) Upon request of a person in this state authorized under 231 subsection (2), or a similarly authorized person in another 232 state, a registration system located in this state shall notify 233 the person of the identities of volunteer health practitioners 234 and whether the practitioners are licensed and in good standing. 235 (4) A host entity is not required to use the services of a 236 volunteer health practitioner even if the practitioner is 237 registered with a registration system that indicates that the 238 practitioner is licensed and in good standing. 239 252.956 Recognition of volunteer health practitioners 240 licensed in other states.— 241 (1) While an emergency declaration is in effect, a 242 volunteer health practitioner, registered with a registration 243 system that complies with s. 252.955 and licensed and in good 244 standing in the state upon which the practitioner's registration 245 is based, may practice in this state to the extent authorized by 246 this part as if the practitioner were licensed in this state. 247 (2) A volunteer health practitioner qualified under 248 subsection (1) is not entitled to the protections of this part 249 if the practitioner is licensed in more than one state and any 250 license of the practitioner is suspended, revoked, or subject to 251 an agency order limiting or restricting practice privileges, or 252 has been voluntarily terminated under threat of sanction. 253 252.957 No effect on credentialing and privileging.— 254 (1) As used in this section: 255 (a) “Credentialing” means obtaining, verifying, and 256 assessing the qualifications of a health practitioner to provide 257 treatment, care, or services in or for a health facility. 258 (b) “Privileging” means the authorizing by an appropriate 259 authority, such as a governing body, of a health practitioner to 260 provide specific treatment, care, or services at a health 261 facility subject to limits based on factors that include 262 license, education, training, experience, competence, health 263 status, and specialized skill. 264 (2) This part does not affect credentialing or privileging 265 standards of a health facility and does not preclude a health 266 facility from waiving or modifying those standards while an 267 emergency declaration is in effect. 268 252.958 Provision of volunteer health or veterinary 269 services; administrative sanctions.— 270 (1) Subject to subsections (2) and (3), a volunteer health 271 practitioner shall adhere to the scope of practice for a 272 similarly licensed practitioner established by the licensing 273 provisions, practice acts, or other laws of this state. 274 (2) Except as otherwise provided in subsection (3), this 275 part does not authorize a volunteer health practitioner to 276 provide services that are outside the practitioner's scope of 277 practice, even if a similarly licensed practitioner in this 278 state would be permitted to provide such services. 279 (3) The Division of Emergency Management, in cooperation 280 with the Department of Health, the Agency for Health Care 281 Administration, and the Board of Veterinary Medicine, may modify 282 or restrict the health or veterinary services that volunteer 283 health practitioners may provide pursuant to this part. An order 284 under this subsection may take effect immediately, without prior 285 notice or comment, and is not a rule pursuant to chapter 120. 286 (4) A host entity may restrict the health or veterinary 287 services that a volunteer health practitioner may provide 288 pursuant to this part. 289 (5) A volunteer health practitioner is not deemed to be 290 engaging in unauthorized practice unless the practitioner has 291 reason to know of any limitation, modification, or restriction 292 under this section or that a similarly licensed practitioner in 293 this state would not be permitted to provide the services. A 294 volunteer health practitioner has reason to know of a 295 limitation, modification, or restriction or that a similarly 296 licensed practitioner in this state would not be permitted to 297 provide a service if: 298 (a) The practitioner knows the limitation, modification, or 299 restriction exists or that a similarly licensed practitioner in 300 this state would not be permitted to provide the service; or 301 (b) From all the facts and circumstances known to the 302 practitioner at the relevant time, a reasonable person would 303 conclude that the limitation, modification, or restriction 304 exists or that a similarly licensed practitioner in this state 305 would not be permitted to provide the service. 306 (6) In addition to the authority granted by the law of this 307 state other than this part to regulate the conduct of health 308 practitioners, a licensing board or other disciplinary authority 309 in this state: 310 (a) May impose administrative sanctions upon a health 311 practitioner licensed in this state for conduct outside of this 312 state in response to an out-of-state emergency; 313 (b) May impose administrative sanctions upon a health 314 practitioner not licensed in this state for conduct in this 315 state in response to an in-state emergency; and 316 (c) Shall report any administrative sanctions imposed upon 317 a practitioner licensed in another state to the appropriate 318 licensing board or other disciplinary authority in any other 319 state in which the practitioner is known to be licensed. 320 (7) In determining whether to impose administrative 321 sanctions under subsection (6), a licensing board or other 322 disciplinary authority shall consider the circumstances in which 323 the conduct took place, including any exigent circumstances, and 324 the practitioner's scope of practice, education, training, 325 experience, and specialized skill. 326 252.959 Relation to other laws.— 327 (1) This part does not limit rights, privileges, or 328 immunities provided to volunteer health practitioners by laws 329 other than this part. Except as otherwise provided in subsection 330 (2), this part does not affect requirements for the use of 331 health practitioners pursuant to the Emergency Management 332 Assistance Compact. 333 (2) The Division of Emergency Management, in cooperation 334 with the Department of Health, the Agency for Health Care 335 Administration, and the Board of Veterinary Medicine, pursuant 336 to the Emergency Management Assistance Compact, may incorporate 337 into the emergency forces of this state volunteer health 338 practitioners who are not officers or employees of this state, a 339 political subdivision of this state, or a municipality or other 340 local government within this state. 341 252.960 Regulatory authority.—The Division of Emergency 342 Management, the Department of Health, the Agency for Health Care 343 Administration, and the Board of Veterinary Medicine may adopt 344 rules to implement this part. In doing so, the division, the 345 department, the agency, and the board shall consult with and 346 consider the recommendations of the entity established to 347 coordinate the implementation of the Emergency Management 348 Assistance Compact and shall also consult with and consider 349 rules adopted by similarly empowered agencies in other states to 350 promote uniformity of application of this part and make the 351 emergency response systems in the various states reasonably 352 compatible. 353 252.961 Limitations on civil liability for volunteer health 354 practitioners; vicarious liability.— 355 (1) Subject to subsection (3), a volunteer health 356 practitioner who provides health or veterinary services pursuant 357 to this part is not liable for damages for an act or omission of 358 the practitioner in providing those services. 359 (2) No person is vicariously liable for damages for an act 360 or omission of a volunteer health practitioner if the 361 practitioner is not liable for the damages under subsection (1). 362 (3) This section does not limit the liability of a 363 volunteer health practitioner for: 364 (a) Willful misconduct or wanton, grossly negligent, 365 reckless, or criminal conduct; 366 (b) An intentional tort; 367 (c) Breach of contract; 368 (d) A claim asserted by a host entity or by an entity 369 located in this or another state which employs or uses the 370 services of the practitioner; or 371 (e) An act or omission relating to the operation of a motor 372 vehicle, vessel, aircraft, or other vehicle. 373 (4) A person that, pursuant to this part, operates, uses, 374 or relies upon information provided by a volunteer health 375 practitioner registration system is not liable for damages for 376 an act or omission relating to such operation, use, or reliance 377 unless the act or omission is an intentional tort or is willful 378 misconduct or wanton, grossly negligent, reckless, or criminal 379 conduct. 380 252.962 Workers' compensation coverage.— 381 (1) For purposes of this section, “injury“ means a physical 382 or mental injury or disease for which an employee of this state 383 who is injured or contracts the disease in the course of the 384 employee's employment would be entitled to benefits under the 385 workers' compensation law of this state. 386 (2) A volunteer health practitioner who dies or is injured 387 as the result of providing health or veterinary services 388 pursuant to this part is deemed to be an employee of this state 389 for the purpose of receiving benefits for the death or injury 390 under chapter 440, the Workers' Compensation Law, if: 391 (a) The practitioner is not otherwise eligible for such 392 benefits for the injury or death under the law of this or of 393 another state; and 394 (b) The practitioner, or in the case of death the 395 practitioner's personal representative, elects coverage under 396 the workers' compensation law of this state by making a claim 397 under that law. 398 (3) The Division of Emergency Management, the Department of 399 Health, the Agency for Health Care Administration, and the Board 400 of Veterinary Medicine shall adopt rules, enter into agreements 401 with other states, or take other measures to facilitate the 402 receipt of benefits for injury or death under the workers' 403 compensation law of this state by volunteer health practitioners 404 who reside in other states, and may waive or modify requirements 405 for filing, processing, and paying claims that unreasonably 406 burden the practitioners. To promote uniformity of application 407 of this part with other states that enact similar legislation, 408 the Division of Emergency Management, the Department of Health, 409 the Agency for Health Care Administration, and the Board of 410 Veterinary Medicine shall consult with and consider the 411 practices for filing, processing, and paying claims by agencies 412 with similar authority in other states. 413 252.963 Uniformity of application and construction.—In 414 applying and construing this uniform act, consideration must be 415 given to the need to promote uniformity of the law with respect 416 to its subject matter among states that enact it. 417 Section 2. This act shall take effect July 1, 2009.